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Texas ABA Therapy Guide

ABA Therapy in Texas: Medicaid, Insurance & How to Get Covered

Texas put ABA on Medicaid in 2022, and state law makes most private insurers cover it too. Below is how STAR Kids, CAP, and Chapter 1355 actually work, which cities have clinics, and how to get a shortlist that matches your child.

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Where can I find ABA therapy in Texas?

ABA therapy in Texas runs center-based and in-home, clustered in Houston (Harris County and suburbs), Dallas-Fort Worth, Austin, and San Antonio, with more clinics in Tyler, Beaumont, Lubbock, and a handful of other cities. Most families pay through STAR Kids Medicaid, a fully insured plan under Texas Insurance Code Chapter 1355, or the state's Children's Autism Program (CAP). Texas was the 50th and last state to add ABA to Medicaid, in February 2022, so coverage that did not exist a few years ago is now on the table for a lot of kids.

Browse the full Texas ABA directory → Estimate ABA therapy cost →

ABA therapy centers in Texas by region

Texas has over 100 active ABA therapy centers. Most sit in Houston and DFW; Austin and San Antonio have plenty of clinics too. Pick a city to compare clinics, which insurance they take, and how long the wait is.

2026 access note

Texas has some of the lowest Medicaid ABA reimbursement rates in the country, and in late 2025 that led at least one large national provider, Autism Learning Partners, to say it would stop offering ABA in Texas as of March 2026. When a big shop leaves, waitlists in some metros get longer. Ask, on the call, whether they still have openings and whether they take STAR Kids.

Dallas-Fort Worth

DFW is the second-biggest ABA market in the state, with clinics spread across the Metroplex rather than one downtown cluster.

Austin

Austin and the suburbs growing next to it have a dense, still-expanding set of ABA clinics.

San Antonio

Bexar County clinics cover families across the San Antonio metro.

East and South Texas

Smaller regional centers for families who do not live in Houston, DFW, Austin, or San Antonio.

Tell us your city and what your child needs. We'll send a shortlist of ABA providers that fit.

How much does ABA therapy cost in Texas, and who pays?

Most Texas families never pay the clinic's full sticker price. They get in through STAR Kids Medicaid, private insurance (which Texas law requires most plans to cover), or CAP. What lands on you is eligibility, copays and deductibles, and hours per week. The cost tool below sketches a range before you start calling.

Estimate your out-of-pocket cost

ABA pricing depends on hours per week, center vs. in-home, and how your plan treats copays and deductibles. The calculator gives a range you can use before you spend an afternoon on hold.

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STAR Kids Medicaid

Texas Medicaid added ABA as a covered benefit in February 2022. Kids in STAR Kids with an ASD diagnosis and a referral can get ABA with no premium. Prior authorization still has to clear first.

Private insurance (Insurance Code Ch. 1355)

Texas law requires most private health plans to cover autism treatment, including ABA. Plans that a large employer self-funds (ERISA) sit outside that mandate, so read the plan documents or ask HR.

Children's Autism Program (CAP)

CAP is state-funded focused ABA at no cost to families who qualify, capped at 180 hours a year. It is not Medicaid. You apply through 2-1-1.

Texas Medicaid and ABA: how STAR Kids actually works

On February 1, 2022, Texas became the 50th and last state to put Applied Behavior Analysis on Medicaid. It runs through the Texas Health Steps-Comprehensive Care Program (THSteps-CCP). The details below come from Texas Health and Human Services and the state's managed care enrollment pages.

Step 0: get an autism diagnosis first

Every ABA payment path in Texas wants a current autism spectrum disorder diagnosis before anyone will authorize hours. That is true for STAR Kids, CAP, and private insurance under Chapter 1355. If you do not have a diagnosis yet, start with the pediatrician, a developmental clinic, or a licensed psychologist. Families already in STAR Kids can ask the managed care organization for a referral to an evaluator.

Three stat cards showing ABA therapy annual cost in Texas by coverage type: zero dollars per year with STAR Kids Medicaid for eligible children, $124,800 per year without any coverage at 20 hours per week and $120 per hour, and a note that Texas private insurance plans must cover ABA therapy under the state autism mandate (Texas Insurance Code Chapter 1355). Source: Texas HHS STAR Kids 2026, Texas Insurance Code Chapter 1355, BACB rate data.

STAR Kids: the main program for children with disabilities

Most kids with autism who qualify for Texas Medicaid land in STAR Kids, a managed care program for children age 20 and younger who get SSI or who are on a Medicaid waiver. It covers basic medical care and long-term supports, including ABA. Each child gets a service coordinator who helps run the care plan.

To get ABA through STAR Kids: confirm Medicaid eligibility, get a current ASD diagnosis from a qualified clinician, get a physician referral for ABA, then call your managed care organization (MCO) and start prior authorization. Common MCOs are Molina, UnitedHealthcare Community Plan, Aetna Better Health, and Superior HealthPlan.

Source: Texas HHS: STAR Kids program overview and eligibility

What Texas Medicaid covers for ABA

Effective February 1, 2022, THSteps-CCP added ABA evaluation and treatment for children and youth with an ASD diagnosis who are on Texas Medicaid and meet program criteria. Covered services include the first ABA evaluation and ongoing treatment aimed at communication, behavior, and daily living. It has to be medically necessary, and the MCO has to prior-authorize it before hours start.

Source: Texas HHS: Medicaid Applied Behavior Analysis flyer (PDF)

Medicaid Buy-In for Children: an option if your income is too high

If your child has a qualifying disability but household income sits above the usual Medicaid cutoff, Medicaid Buy-In for Children lets you buy Medicaid at a sliding-scale premium. That matters when employer coverage has huge ABA deductibles, because Medicaid can sit as a secondary payer.

Source: Texas HHS: Medicaid Buy-In for Children

Before you rely on Medicaid coverage

This page summarizes public Texas state information. It is not legal or medical advice. Eligibility, covered services, and prior-auth rules move. Confirm benefits with your MCO or the Texas HHS Medicaid enrollment line at 877-782-6440 before you make a plan around them.

Texas Children's Autism Program (CAP): focused ABA at no cost

Separate from Medicaid, Texas HHS Children's Autism Program pays for focused ABA through local contractors at no cost to families who qualify. It is narrower than full Medicaid ABA, and it is useful while you wait on Medicaid approval or a private-plan prior auth.

Who qualifies

  • Child has a documented autism spectrum disorder diagnosis from a qualified professional
  • Child is between 3 and 15 years old (services end on the 16th birthday)
  • Child is a Texas resident

Program limits to know

  • Focused ABA only: targets specific behaviors, not all developmental needs
  • Limited to 180 hours within any 12-month period
  • Lifetime maximum of 720 hours per child
  • Parent training is required; 85% attendance required for child and parent

How to apply for CAP

All CAP hours run through contractors in communities around Texas. The fastest start is 2-1-1 or a contractor search on 211texas.org. You can also call the Children's Autism Program office.

Phone

512-438-5356

M-F, 8am-5pm CT

Email

Childrens.Autism.Program@hhs.texas.gov

Statewide referral

Call 2-1-1 or visit 211texas.org

Source: Texas HHS: Children's Autism Program

Texas private insurance mandate: Insurance Code Chapter 1355

Texas Insurance Code Chapter 1355 (Sec. 1355.015) requires most state-regulated private health plans to cover autism spectrum disorder treatment, including ABA. The mandate started with House Bill 1919 in 2007. It is separate from Medicaid and applies to employer-sponsored and individual-market insurance that Texas regulates.

What Chapter 1355 requires

Under Chapter 1355, health benefit plans issued or renewed in Texas must cover diagnosis and treatment of autism spectrum disorder. That includes behavioral health treatment (ABA), speech-language pathology, occupational therapy, and physical therapy. Plans cannot put annual or lifetime dollar caps on those benefits that sit below the caps they use for other medical and surgical benefits.

Ask HR this before you count on the mandate

The state rule only binds plans Texas regulates. A lot of large employers "self-fund," which means the employer pays claims and buys an administrator, not a fully insured policy. Those plans follow federal ERISA, not Chapter 1355. If the card says "administered by" an insurer but your employer is the plan sponsor, assume it might be self-funded until HR says otherwise.

Ask HR whether the plan is "fully insured" or "self-funded." Fully insured plans have to follow Chapter 1355. Self-funded plans do not, though many still cover ABA anyway.

If your insurer denies ABA coverage

On a fully insured Texas plan, a denial of ABA gets an internal appeal and then an external review. Texas makes the plan put appeal rights in writing with every denial. You can also complain to the Texas Department of Insurance at 800-252-3439.

How to choose an ABA provider in Texas

Texas has national chains with dozens of sites and small independent practices. Use the checklist when you compare clinics and when you call intake.

Horizontal bar chart showing recommended weekly ABA therapy hours by autism support level: high support needs ages 2 to 5 receive 35 hours per week, moderate support needs receive 20 hours per week, and lower support needs receive 12 hours per week. Source: Journal of Applied Behavior Analysis, Lovaas 1987 and subsequent replications, BACB guidelines.
These weekly hour ranges are typical starting points, not a formula. Your child's BCBA sets intensity from the assessment, the goals, and how the child responds, and the hours the plan authorizes can be different.
Setting and schedule
  • Center-based, in-home, school-based, or telehealth
  • Full-day, half-day, or after-school hours
  • Drive time across the Houston or DFW metro
Clinical model
  • BCBA-to-child ratio and how often the BCBA observes sessions
  • Whether RBTs deliver the day-to-day sessions
  • Parent training built into the program
Access and timing
  • Current waitlist length
  • Whether an autism diagnosis is required before intake
  • Whether evaluations are available in-house
Payment fit
  • Whether STAR Kids Medicaid is accepted
  • Which commercial plans the center accepts (and whether prior auth is handled in-house)
  • Sliding-scale or self-pay options if coverage is pending

Compare providers across nearby cities

In the Houston metro, providers in Pearland, Katy, and The Woodlands often have shorter waitlists than central Houston. In DFW, families in Plano or Carrollton sometimes get into intake faster than Dallas proper. Check two or three nearby cities before you park on one waitlist.

Frequently Asked Questions About ABA Therapy in Texas

Does Texas Medicaid cover ABA therapy?
Yes. Effective February 1, 2022, Texas added ABA evaluation and treatment under the Texas Health Steps-Comprehensive Care Program for children with an ASD diagnosis who are on Texas Medicaid. Most kids with disabilities get that through STAR Kids managed care. The MCO has to prior-authorize hours before they start. See the Texas HHS Medicaid ABA coverage flyer (PDF) for current program details.
What is STAR Kids and does it cover ABA?
STAR Kids is Texas Medicaid managed care for children age 20 and younger who get SSI or who are on a Medicaid waiver. It covers basic medical care and long-term supports, including ABA for kids with autism. Each child gets a service coordinator. For ABA you still need a current ASD diagnosis, a physician referral, and prior authorization from the STAR Kids MCO.
What is the Texas Children's Autism Program (CAP)?
CAP is a Texas HHS program that pays for focused ABA at no cost for eligible kids ages 3-15 with a documented ASD diagnosis. It is not Medicaid. Hours cap at 180 a year and 720 lifetime, and a parent has to participate. Call 2-1-1 or search 211texas.org for a contractor. Families use it as a bridge while Medicaid or a private prior auth is still pending.
Does Texas require private insurance to cover ABA?
Yes, for most plans. Texas Insurance Code Chapter 1355 (Sec. 1355.015) requires fully insured health plans to cover autism treatment including ABA. Self-funded ERISA plans, common at large employers, follow federal law and skip the state mandate. Ask HR whether your plan is "fully insured" or "self-funded." If a fully insured plan denies ABA, you can appeal and then ask for external review. The Texas Department of Insurance is at 800-252-3439.
How do I find ABA therapy in Houston or Dallas?
Use the city links in the regions section above. For Houston, start with Houston and compare nearby suburbs like Pearland, Katy, and The Woodlands, where the wait is sometimes shorter. For DFW, check Dallas, Plano, and Carrollton. You can also ask us to match you with verified clinics that take your insurance.
What can I do if my ABA claim is denied?
On a fully insured Texas plan you file an internal appeal, and if that fails you request an independent external review. Texas makes the plan include written appeal instructions with every denial. Denied ABA is often overturned at appeal or external review when the request includes the BCBA's assessment and treatment plan. The Texas Department of Insurance is at 800-252-3439.

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